Press release - Analytical report “Hospital treatment 2023–2025”
Hospital treatment 2023–2025:
194.230 patients, fewer cardiac hospitalisations and a stable system
The HIF analytical report on hospital treatment in the period 2023–2025 reveals the key developments in the Macedonian hospital system: an increase in the number of treated patients, an increased budget and gradual strengthening of the capacities of health institutions.
Key indicators:
- 194.230 treated patients in 2025 (+5,1% compared with 2023)
- 32,5 billion denars budget in 2025 (+24% in two years)
- 1,55 average CMI in 2025
POSITIVE TRENDS: MORE PATIENTS AND BROADER ACCESS
The number of hospital cases is growing steadily — from 184.829 in 2023 to 194.230 in 2025 (+5,1%), with growth in almost all types of health institutions, except clinical hospitals.
Eye diseases record +21,9% more hospitalisations, and diseases of the musculoskeletal system +28,9%, indicating compensation for delayed orthopaedic interventions after the pandemic.
Hospitalisations due to cardiovascular diseases record a decline from 26.651 to 25.876 cases (–2,9%) — a positive signal indicating possible improvements.
Cardiovascular diseases still remain in first place by value of services, with 2,08 billion denars, but the downward trend in hospitalisations is encouraging.
Contractual budgets with PHIs record growth of 24% over two years — from 26,2 to 32,5 billion denars, with the largest absolute increase at the university clinics (+33%).
CMI IN FOCUS: WHICH INSTITUTIONS TREAT THE MOST COMPLEX CASES?
The analysis by institution reveals a clear structure in terms of treatment complexity.
At the top are the cardiac surgery hospitals:
- PHI “Sistina” — CMI 18,4
- PHI “Filip Vtori” — CMI 15,4
They are followed by:
- UC for Haematology — CMI 9,8
- UC for State Cardiac Surgery — CMI 9,1
Among general hospitals, CGH “8 September” with CMI 1,95 stands out as the only general hospital with a value at clinic level and practically functions as a referral centre for Skopje.
Among regional hospitals, CH Shtip leads with CMI 1,31, while CH Bitola recorded the largest increase in 2025 (+0,09).
It is particularly significant that 9 of 12 general hospitals improved their CMI in 2025 compared with 2024.
GH Kumanovo has the largest growth (+0,091), while GH Strumica for the first time exceeds the threshold of CMI 1,0.
This indicates that regional hospitals are gradually taking on more complex cases, which is a positive signal for the decentralisation of health care and better access for citizens outside Skopje.
It is important to emphasise that a higher CMI does not necessarily mean a “better” institution, but often indicates narrower specialisation. CMI is an analytical tool for comparison in context, not an absolute rating.
The full analytical report “Hospital treatment 2023–2025” and the CMI analysis are available on request through the press service of the HIFRNM.
Data source:
Annual reports of the Health Insurance Fund of Macedonia for 2023, 2024 and 2025; Casemix analyses by health institutions for the period 2023–2025.
The analysis was prepared on the basis of official HIF data.
